Barriers to equitable use of patient-reported outcomes in diabetes management

INTRODUCTION: Inequity in diabetes-related health due to socioeconomic status is a recognised challenge. A patient-centred approach tailors care to individual needs, and patient-reported outcome (PRO) measures can be a valuable tool in this process. In Denmark, a new diabetes-specific PRO questionnaire has been developed to enable a systematic assessment of patients' experiences and potential barriers to care. This study examined participation in the PRO diabetes questionnaire and its relation to socioeconomic status and severe psychiatric comorbidity.

METHODS: This register study included people with diabetes who were invited to complete the questionnaire. Participation status was analysed using multiple logistic regression models, incorporating variables related to socioeconomic status.

RESULTS: Socioeconomic status was a significant overall predictor of questionnaire participation, with non-Western immigration showing the strongest association. Additionally, Western immigration, low educational attainment and severe psychiatric comorbidity were significant predictors in subsets of the regression models.

CONCLUSIONS: This study highlights disparities in participation in the PRO diabetes questionnaire related to socioeconomic status and severe psychiatric comorbidity. To promote equitable access and reduce diabetes-related health inequalities, targeted efforts are needed to support vulnerable groups in engaging with patient-centred interventions.

FUNDING: Steno Diabetes Center Copenhagen TRIAL REGISTRATION. Pactius.